Allegheny Health Network Works to Decrease Heart Attack Response Time

According to the Centers for Disease Control and Prevention, 715,000 Americans have a heart attack each year.

The Allegheny Health Network hopes to help these people with its new “First Contact-to-Balloon” initiative.

“First Contact-to-Balloon,” refers to the time when a patient first calls for a paramedic to when their blocked blood vessel is actually opened.

The initiative will enable Emergency Medical Services (EMS) providers to diagnose patients from the field and then alert hospital cardiac catheterization teams to prepare for their arrival.

It specifically aims to improve the outcome of ST-elevation myocardial infarction (STEMI), which is a heart attack in which a coronary artery is completely blocked.

Bruce MacLeod, West Penn Emergency Department Medical Director, said they are trying to reduce the time between the beginning of a patient’s heart attack to when their artery is actually opened at the hospital.

“The strategy is that when a paramedic goes into the house - and we try to encourage patients to call when they have chest pain - that they put an electrocardiogram on, get a 12-Lead ECG, or a heart trace, and if they see a myocardial infarction, then they call at that time and activate the Cath-lab team,” MacLeod said.

MacLeod said they have established a program to train medics to recognize STEMI, but most of the medics already have the ability to use the equipment.

“It turns out that 95 percent of the ambulance companies and paramedic services in western Pennsylvania actually have the ability to do 12-Lead heart tracing,” MacLeod said.

The older system - the “door-to-balloon time” - tracked the time between the patient’s arrival at the hospital to the opening of their vessel.

The American Heart Association calls for a “door-to-balloon time,” of 90 minutes or less.

Saint Vincent’s average “door-to-balloon” time was 45 minutes. Forbes’s average was 65 minutes and Jefferson’s was 66 minutes.

MacLeod said they’ve found a lot of improvement at the hospital level, but they need to improve the pre-hospital timing.

“There is this big push to reduce the time, to get there as quickly as possible because we know the most important variable is time,” MacLeod said. “And the quicker we can open that blood vessel by passing a stent through there or opening it up or evacuating the clot, the better off the patient does.”

Forbes, Jefferson and Saint Vincent Hospital have already switched to the new initiative.